Reporting Response Entropy Along With State Entropy Would Enhance Differentiating Nociception

2021 ◽  
Vol 133 (3) ◽  
pp. e43-e43 ◽  
Author(s):  
Mehmet S. Ozcan ◽  
Jean G. Charchaflieh
Keyword(s):  
State Entropy ◽  
Response Entropy

scholarly journals Impact of General Anesthesia Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients—A Prospective Observational Randomized Monocentric Study

Entropy ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 356 ◽  
Author(s):  
Anca Raluca Dinu ◽  
Alexandru Florin Rogobete ◽  
Sonia Elena Popovici ◽  
Ovidiu Horea Bedreag ◽  
Marius Papurica ◽  
...  
Keyword(s):  
Study Groups ◽  
Depth Of Anesthesia ◽  
Hemodynamic Stability ◽  
State Entropy ◽  
Multimodal Monitoring ◽  
Response Entropy ◽  
Group A ◽  
Group B ◽  
The Individual ◽  
The Impact

Laparoscopic cholecystectomy is one of the most frequently performed interventions in general surgery departments. Some of the most important aims in achieving perioperative stability in these patients is diminishing the impact of general anesthesia on the hemodynamic stability and the optimization of anesthetic drug doses based on the individual clinical profile of each patient. The objective of this study is the evaluation of the impact, as monitored through entropy (both state entropy (SE) and response entropy (RE)), that the depth of anesthesia has on the hemodynamic stability, as well as the doses of volatile anesthetic. A prospective, observational, randomized, and monocentric study was carried out between January and December 2019 in the Clinic of Anesthesia and Intensive Care of the “Pius Brînzeu” Emergency County Hospital in Timișoara, Romania. The patients included in the study were divided in two study groups: patients in Group A (target group) received multimodal monitoring, which included monitoring of standard parameters and of entropy (SE and RE); while the patients in Group B (control group) only received standard monitoring. The anesthetic dose in group A was optimized to achieve a target entropy of 40–60. A total of 68 patients met the inclusion criteria and were allocated to one of the two study groups: group A (N = 43) or group B (N = 25). There were no statistically significant differences identified between the two groups for both demographical and clinical characteristics (p > 0.05). Statistically significant differences were identified for the number of hypotensive episodes (p = 0.011, 95% CI: [0.1851, 0.7042]) and for the number of episodes of bradycardia (p < 0.0001, 95% CI: [0.3296, 0.7923]). Moreover, there was a significant difference in the Sevoflurane consumption between the two study groups (p = 0.0498, 95% CI: [−0.3942, 0.9047]). The implementation of the multimodal monitoring protocol, including the standard parameters and the measurement of entropy for determining the depth of anesthesia (SE and RE) led to a considerable improvement in perioperative hemodynamic stability. Furthermore, optimizing the doses of anesthetic drugs based on the individual clinical profile of each patient led to a considerable decrease in drug consumption, as well as to a lower incidence of hemodynamic side-effects.

scholarly journals Impact of General Anaesthesia - Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients. A Prospective Observational Randomized Monocentric Study

2020 ◽  
Author(s):  
Anca Raluca Dinu ◽  
Alexandru Florin Rogobete ◽  
Sonia Elena Popovici ◽  
Ovidiu Horea Bedreag ◽  
Marius Papurica ◽  
...  
Keyword(s):  
Study Groups ◽  
Depth Of Anesthesia ◽  
Hemodynamic Stability ◽  
State Entropy ◽  
Multimodal Monitoring ◽  
Response Entropy ◽  
Group A ◽  
Group B ◽  
The Individual ◽  
The Impact

Study background and aims: Laparoscopic cholecystectomy is one of the most frequently performed interventions in departments of general surgery. One of the most important aims in achieving perioperative stability of these patients is diminishing the impact of general anesthesia on the hemodynamic stability and the optimization of anesthetic drug doses based on the individual clinical profile of each patient. The objective of this study is the evaluation of the impact monitoring the depth of anesthesia through Entropy (state entropy &ndash; SE and response entropy -RE) has on the hemodynamic stability and on the doses of volatile anesthetic. Material and Methods: This is a prospective, observational, randomized, monocentric study carried out between January 2019 and December 2019 in the Clinic of Anesthesia and Intensive Care from the &ldquo;Pius Br&icirc;nzeu&rdquo; Emergency County Hospital in Timișoara, Romania. The patients included in the study were divided in two study groups; patients in Group A (target group) received multimodal monitoring that included monitoring of standard parameters and of Entropy (SE and RE), while patients in Group B (control group) only received standard monitoring. Anesthetic dose in group A were optimized to achieve a target entropy of 40-60. Results: 68 patients met the inclusion criteria and were allocated to one of the two study groups, Group A (N=43) and Group B (N=25). There were no statistically significant differences identified between the two groups for both demographical and clinical data (p&gt;0.05). Statistically significant differences have been identified for the number of hypotensive episodes (p = 0.011, 95% CI 0.1851 to 0.7042) and for the number of episodes of bradycardia (p &lt; 0.0001, 95% CI 0.3296 to 0.7923). Moreover, there was a significant difference in the Sevoflurane consumption between the two study groups (p = 0.0498, 95% CI -0.3942 to 0.9047). Conclusions: The implementation of the multimodal monitoring protocol that includes the standard parameters and the measurement of Entropy for determining the depth of anesthesia (SE and RE) lead to a considerable improvement in perioperative hemodynamic stability. Optimizing the doses of anesthetic drugs based on the individual clinical profile of each patient leads to a considerable decrease in drug consumption as well as to a lower incidence of hemodynamic side-effects.

scholarly journals Bispectral Index, Entropy, and Quantitative Electroencephalogram during Single-agent Xenon Anesthesia

2008 ◽  
Vol 108 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Ruut M. Laitio ◽  
Kimmo Kaskinoro ◽  
Mika O. K. Särkelä ◽  
Kaike K. Kaisti ◽  
Elina Salmi ◽  
...  
Keyword(s):  
Steady State ◽  
Bispectral Index ◽  
Single Agent ◽  
Brain Regions ◽  
Total Power ◽  
State Entropy ◽  
Loss Of Response ◽  
Prediction Probability ◽  
Response Entropy ◽  
Quantitative Electroencephalogram

Background The aim was to evaluate the performance of anesthesia depth monitors, Bispectral Index (BIS) and Entropy, during single-agent xenon anesthesia in 17 healthy subjects. Methods After mask induction with xenon and intubation, anesthesia was continued with xenon only. BIS, State Entropy and Response Entropy, and electroencephalogram were monitored throughout induction, steady-state anesthesia, and emergence. The performance of BIS, State Entropy, and Response Entropy were evaluated with prediction probability, sensitivity, and specificity analyses. The power spectrum of the raw electroencephalogram signal was calculated. Results The mean (SD) xenon concentration during anesthesia was 66.4% (2.4%). BIS, State Entropy, and Response Entropy demonstrated low prediction probability values at loss of response (0.455, 0.656, and 0.619) but 1 min after that the values were high (0.804, 0.941, and 0.929). Thereafter, equally good performance was demonstrated for all indices. At emergence, the prediction probability values to distinguish between steady-state anesthesia and return of response for BIS, State Entropy, and Response Entropy were 0.988, 0.892, and 0.992. No statistical differences between the performances of the monitors were observed. Quantitative electroencephalogram analyses showed generalized increase in total power (P &lt; 0.001), delta (P &lt; 0.001) and theta activity (P &lt; 0.001), and increased alpha activity (P = 0.003) in the frontal brain regions. Conclusions Electroencephalogram-derived depth of sedation indices BIS and Entropy showed a delay to detect loss of response during induction of xenon anesthesia. Both monitors performed well in distinguishing between conscious and unconscious states during steady-state anesthesia. Xenon-induced changes in electroencephalogram closely resemble those induced by propofol.

scholarly journals Monitoring the depth of anaesthesia using the new modified entropy sensors during supratentorial craniotomy: Our experience

2015 ◽  
Vol 02 (01) ◽  
pp. 028-032
Author(s):  
Richa Sharma ◽  
Pirjo Manninen ◽  
Lashmikumar Venkatraghavan
Keyword(s):  
Depth Of Anaesthesia ◽  
State Entropy ◽  
Supratentorial Craniotomy ◽  
Response Entropy ◽  
Anaesthetic Depth ◽  
Intraoperative Period ◽  
Clinical Indices ◽  
Induction Of Anaesthesia ◽  
New Sensors ◽  
Modified Entropy

Abstract Background: Monitoring the depth of anaesthesia can be a challenge in patients undergoing supratentorial craniotomy because the conventional sensors for both bispectral index and entropy monitors lose their contact with a brain after scalp elevation. The new sensors for the entropy monitor are more flexible and can be placed in different locations. The purpose of this study was to determine the feasibility on the use of new GE entropy sensors in monitoring depth of anaesthesia in patients undergoing supratentorial craniotomy. Materials and Methods: We retrospectively reviewed the data from 20 consecutive patients undergoing supratentorial craniotomy who had the monitoring of the depth of anaesthesia using modified entropy sensors. Prior to the induction of anaesthesia, the new GE entropy sensor (P/N M1038681) was applied in a modified fashion. We measured the state entropy (SE) and response entropy (RE) at 12 perioperative time points. Entropy values were compared with the clinical indices of depth of anaesthesia. Results: Data from 20 consecutive patients (orbitozygomatic craniotomy [10] and bifrontal craniotomy [10]) were analysed. Monitoring was possible in all the patients. The changes in entropy values correlated with clinical indices of depth of anaesthesia. However, some patients showed variations in absolute values (RE and SE) during the intraoperative period without any changes in the level of anaesthetic depth. Conclusions: Monitoring the depth of anaesthesia is feasible with the use of new entropy sensors in patients undergoing supratentorial craniotomy. In contrast to standard sensors, the new sensors offer flexibility with the placement.

scholarly journals Feasibility study for the administration of remifentanil based on the difference between response entropy and state entropy †

2007 ◽  
Vol 98 (6) ◽  
pp. 785-791 ◽  
Author(s):  
D.M. Mathews ◽  
P.M. Cirullo ◽  
M.M.R.F. Struys ◽  
T. De Smet ◽  
R.J. Malik ◽  
...  
Keyword(s):  
Feasibility Study ◽  
State Entropy ◽  
Response Entropy ◽  
The Difference

The Effects of Ketamine and Rocuronium on the A-Line® Auditory Evoked Potential Index, Bispectral Index, and Spectral Entropy Monitor during Steady State Propofol and Remifentanil Anesthesia

2006 ◽  
Vol 105 (6) ◽  
pp. 1122-1134 ◽  
Author(s):  
Hugo E. M. Vereecke ◽  
Ann L. Vanluchene ◽  
Eric P. Mortier ◽  
Karel Everaert ◽  
Michel M. R. F. Struys
Keyword(s):  
Steady State ◽  
Bispectral Index ◽  
Evoked Potential ◽  
Auditory Evoked Potential ◽  
Control Group ◽  
Mean Values ◽  
State Entropy ◽  
Potential Index ◽  
Group Response ◽  
Response Entropy

Background The authors studied the effects of ketamine and rocuronium on the Bispectral Index, A-Line auditory evoked potential index, state entropy, and response entropy during a calculated steady state anesthesia with propofol and remifentanil. Methods After ethics committee approval, 42 patients were allocated to four groups. Baseline measurements were performed after implementing a calculated steady state anesthesia with propofol and remifentanil. The control group received no additional medication. The ketamine group received a bolus and continuous infusion of ketamine. The rocuronium group received a bolus of rocuronium. The rocuronium-ketamine group received both. All data were stored during 15 min after baseline. After inspection of the raw data, the authors conducted an explorative statistical analysis. Results No significant changes were found in the control group for any of the monitors. Mean values decreased in the rocuronium group for the A-Line auditory evoked potential index, Bispectral Index, and response entropy, but not for state entropy. In the ketamine group, the A-Line auditory evoked potential index and Bispectral Index did not change significantly, but state and response entropy increased. In the rocuronium-ketamine group, the A-Line auditory evoked potential index and Bispectral Index did not decrease as found in the rocuronium group. Response and state entropy increased significantly. Conclusions The response of all monitors after ketamine administration is not affected by simultaneous administration of rocuronium. Interpretation of all studied indices must be done cautiously while taking into account the clinical setting during measurement.

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